Monday 8 October 2012 09.42 EDT
First published on Monday 8 October 2012 09.42 EDT

A court has allowed a hospital trust to withhold live-saving treatment from a severely brain-damaged man if his condition deteriorates, it has emerged.

The wife and two of the adult sons of a 55-year-old Muslim man, known only as L, argued that he was continuing to improve and it would be wrong for clinical staff at Pennine Acute Hospitals NHS Trust to withhold ventilation or resuscitation in the event of a cardiac or respiratory arrest. The man cannot be identified for legal reasons.

But Mr Justice Moylan, sitting at the court of protection in London on Monday, ruled that the balance was "firmly in favour" of a declaration that it would be lawful to withhold treatment. He said it sounded harsh, but treatment would prolong L's death and would not prolong his life "in any meaningful way".

"It would result in death being characterised by a series of harmful interventions without any realistic prospect of such treatment producing any benefit," he said.

The judge refused the family permission to appeal, but they may still ask the court of appeal to intervene.

Relatives of L, from Greater Manchester, have been fighting a decision by the trust that he was beyond recovery after a cardiac arrest in July that led to brain damage. His doctors had sought an assurance from the court that they did not have to resuscitate him or put him on a ventilator should his condition become life-threatening.

L's family had previously told the court that they did not believe he was beyond hope of recovery and that their religion, Islam, required that everything possible should be done to keep him alive.

In August, the family said they felt vindicated during court proceedings after a dramatic video emerged that suggested he might not be in a vegetative state. The footage showed the man responding to requests and commands. A neurologist said L was in a minimally conscious state and could not rule out the possibility of further progress, and even verbal communication.

But the trust argued that improvements in L's condition witnessed by his family remained so minimal that active resuscitation would be futile and could lead to an undignified and traumatic death. Returning to court after an adjournment, the trust's lawyers argued that it would still not be in L's best interests to receive active resuscitation.

They said his treatment should be limited to what doctors say is reasonably required to "maintain his dignity and relieve such pain and discomfort as he may feel".

Family members, however, disagreed and said he was displaying increased awareness of his surroundings and responding to family members.